Eyes Flashcards
Corneal Ulcer Presentation
Soft contact lens wearer Severe eye pain Foreign body sensation Tearing Photophobia
Corneal Ulcer Physical Exam
Use penlight/slit lamp/fluorescein Whitish lesion on cornea
Corneal Ulcer Treatment
refer to ED
Herpes Keratitis Presentation
Acute onset of unilateral sxs Severe eye pain Blurred vision Tearing Photophobia
Herpes Keratitis Physical Exam
Fluorescein dye/strips
NOT SPLIT LAMP
Fern-like lines on cornea
Herpes Keratitis Treatment
Refer to ED
Corneal Abrasions Presentation
Severe eye pain
Tearing
Foreign body sensation
Round or irregular shaped abrasions on cornea
Acute Angle-Closure Glaucoma Presentation
Elderly Acute onset severe eye pain Headache N/V Halos around lights Lacrimation Decreased vision
Acute Angle-Closure Glaucoma Physical Exam
Mid/dilated oval pupil 4-6mm Cloudy cornea Cupping of optic nerve Conjunctival inj Increased lacrimation
Acute Angle-Closure Glaucoma Treatment
Refer to ED
Optic Neuritis Presentation
Caucasian women 20-30 Loss of visual acuity over hr-days Central blind spot Aphasia, parenthesis, abnormal gait Fatigue Increase temp worsens sxs Recurrent episodes
Optic Neuritis Treatment
Refer to neurologist
Orbital Cellulitis Presentation
Acute onset Erythematous swollen eyelid Proptosis Eye pain with movement Reduced EOMs Recent rhino sinusitis/URI
Orbital Cellulitis Treatment
Refer to ED
Retinal Detachment Presentation
Sudden onset of floaters
Flashes of light (photopsia)
Curtain vision
Retinal Detachment Treatment
Refer to ED
Blepharitis Presentation
Inflamed edges of eyelids
Irritated, itchy, scale
Assoc w/ dandruff, seborrheic derm, rosacea
Visual Fields of Confrontation
Peripheral vision
20/60 meaning
Patient can see at 20 feet what normal vision can see at 60
Contact lens-related keratitis presentation
Contact lenses irresponsible wearer Acute onset Red eye Blurred vision Tearing Photophobia Foreign body sensation
Contact lens-related keratitis pharm treatment
Topical ophthalmic abx Ciprofloxacin Ofloxacin Trimethoprim-polymyxin B 3-5x/day
Eye pain prescription
Topical aculuar 1 gtt qid
Hydrocodone with acetaminophen
(use for 48 hours)
Hordeolum (stye) presentation
Acute onset Swollen, red, warm abscess of hair follicle and sebaceous gland of eyelid Slow growing May spontaneously rupture H/o blepharitis
Hordeolum (stye) treatment
Hot compress x 5-10 min bid-tid until drainage
Dicloxacillin or erythromycin PO qid if preseptal cellulitis
Refer to optho for I&D if needed
Chalazion presentation
Gradual onset Small superficial nodule on upper eyelid Feels like bead Discrete and movable Painless Slow growing May cause blurred vision
Chalazion treatment
Refer to optho for I&D or corticosteroid inj
Pinguecula presentation
Raised yellow to white, small round growth in bulbar conjuctiva
chronic sun exposure
Pterygium presentation
Yellow triangular, wedge shaped thickening of conjunctive
Extends across cornea on the nasal side
Chronic sun exposure
Foreign body sensation
Pterygium treatment
Refer to optho for weak steroid drops
Artificial tears for irritation
Sunglasses with UVAB protection
Subconjunctival Hemorrhage Presentation
Sudden onset
Bright red blood in one eye
Painless
C/b coughing, sneezing, straining, anticoags, eye trauma
Primary open-angle glaucoma presentation
Elderly, Diabetics African or Caucasian Gradual onset Increased IOP >22 Peripheral vision lost first (missing words when reading) Disc cupping
How to check IOP?
Tonometer
Normal IOP
8-22 mmHg
Primary open angle glaucoma treatment
Betimol 0.5% drops (BB)
Latanoprost drops (prostaglandin)
Bronchospasm (c/i asthma, COPD), bradycardia (c/i HF, heart block)
Anterior Uveitis Presentation
Insidious onset of eye pain
Conjunctival injection
No discharge like in conjunctivitis
Anterior Uveitis Treatment
Refer to optho w/i 24 hours
Blepharitis treatment
Johnson’s baby shampoo scrub
Erythromycin drops to eyelids bid
Warm compresses bid for itch/debris
Age-related macular degeneration presentation
Smokers Elderly Gradual or sudden onset Painless Loss of central vision, peripheral intact Straight lines distorted/curved
Age-related macular degeneration treatment
Amsler grid
Refer to optho for lutein and zeanthin w/ zinc
Sjörgen’s Syndrome presentation
AI disorder
Dry eyes
Dry mouth
Sxs > 3 months
Sandy/gritty sensation
Using artificial tears
Dental carries
Inflamed salivary glands
Sjörgen’s Syndrome Treatment
Refer to rheumatology
Ectropion
Eyelid turned out
May cause dry eye
Entroption
Eyelid turned in
May cause irritation
Causes of herpes keratitis
Herpes simplex self-inoculation from cold sore
Varicella zoster of trigeminal nerve (CN V)
Diabetic retinopathy finding
Cotton wool spots
Hypertensive retinopathy finding
Copper and silver wire arterioles
Nicking
Cataracts presentation
Difficulty with glare esp at night
Halos around lights
Blurred vision
